Early identification of pressure injuries in people with dark skin tones: Qualitative perspectives from community-based patients and their carers.

Abstract

To examine the personal experiences and perceptions of people with dark skin tones and their carers, in relation to pressure injury. Qualitative study using semi-structured interviews. Twenty-two interviews with people with dark skin tone and/or their family carers, who were known to and visited by community nurses for pressure area management or who had been identified as being at high risk for developing a pressure injury were carried out. Thematic analysis of the interview transcripts revealed that skin discolouration towards a darker hue than usual was the commonest symptom identified by participants as a sign of altered skin integrity and potential pressure damage. Four main overarching themes were revealed through comprehensive analysis of the transcripts: (1) indicators of pressure injury; (2) experienced symptoms of pressure damage; (3) trust in healthcare workers; and (4) improving care for populations with dark skin tones. The findings from this study clearly present how early-stage pressure damage is identified among people with dark skin tones. These findings have the potential to reduce health inequality by influencing and informing clinical policies and strategies in practice. Findings could also lead to the development of patient-informed educational strategies for nurses and health workers which will enable the early identification of pressure ulcers among people with dark skin tones. Further research is needed to better understand health disparities in relation to preventable patient safety harm. The findings demonstrate the importance of engaging with and listening to the stories and experiences of people living with pressure damage to help in the early recognition of pressure injuries. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed. A project steering group reviewed information sheets for participants and checked the interview questions were relevant and suitable.